ObjectiveTo clarify the knowledge and practical skills needed for cancer pain management among nurses on remote islands in Japan and related factors nationwide.SettingDue to geographical factors, nurses working on remote islands in Japan have few opportunities to attend training programs, which makes it difficult to acquire the knowledge and practical skills needed to provide pain management for patients with cancer.MethodsWe conducted a self‐administered questionnaire survey regarding knowledge and practical skills in pain management for patients with cancer.DesignCross‐sectional study.ParticipantsNurses working in cancer pain care in medical facilities and home care on remote islands throughout Japan.ResultsWe analysed 128 responses. Regarding knowledge, the average accuracy level was 49.1%. Items with a low accuracy rate included selecting medicine according to the type of pain and the patient's condition. Regarding practice, the items with low scores included analgesics appropriate for the type of pain and relating physical pain to mental, social and spiritual aspects. The most common significant factor in both knowledge and practice was related to postgraduate training.ConclusionsThese findings suggest that to improve the knowledge and practical skills for cancer pain management among nurses on remote islands in Japan, it is necessary to incorporate clinical reasoning into basic education and establish remote education systems and consultation systems with other facilities.